Individual provider Active NPI

Justin A Tourtillott, AU.D.

  • Audiologist
  • Topeka, KS
National Provider Identifier
1801974803
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1996 Issued in KS
Practice address
6001 SW 6TH Ave
Suite 115
Topeka, KS 66615-1011
Phone
(785) 271-2284
Fax
(785) 271-2286
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1996 KS Primary

Addresses

Primary practice location

6001 SW 6TH Ave
Suite 115
Topeka, KS 66615-1011

Mailing address

6001 SW 6TH Ave
Suite 115
Topeka, KS 66615-1004
Phone (785) 271-2284

Other identifiers 1

IdentifierTypeStateIssuer
200579640AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040107000553 KS Practitioner - Qualified Audiologist 1052210275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1996KSMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1801974803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 SW 6TH AVE",
            "address_2": "SUITE 115",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666151004",
            "telephone_number": "785-271-2284",
            "fax_number": "785-271-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 SW 6TH AVE",
            "address_2": "SUITE 115",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666151011",
            "telephone_number": "785-271-2284",
            "fax_number": "785-271-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOURTILLOTT",
        "first_name": "JUSTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KS",
            "license": "1996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200579640A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.